Arthritis has eaten away all the cartilage on Frank Stonich's left hip, so he was pleased to hear he'd be the first person in California to receive the ball-and-socket being introduced by Dr. Robert Gilbert of California Pacific Orthopaedics & Sports Medicine.

The device, called the Birmingham Hip Resurfacing System, (BHR) is less invasive than total hip replacement because it saves the knob at the top of the thigh bone. Instead of being sawed off, the head of the femur is shaved to fit under a shiny hat that looks like a mushroom. Approved by the FDA on May 10, resurfacing has been shown to have a faster recovery and leave a greater range of motion than replacement, "Wow. It's kind of neat and kind of scary at the same time," Stonich, 58, was saying an hour or two before being wheeled into surgery on the third floor of the California Street Campus of California Pacific Medical Center. This being the last day he could complain about his old hip, he didn't mind piling it on. "I can't sit or walk for any kind of length. I can't go upstairs, can't do anything," he says. "It's messing up my spine. Its messing up my knee and it's shortened my leg."

While Stonich is in getting prepped, Gilbert, 65, explains that resurfacing was common in the early 1980s, involving a ball on the femur and a cup in the socket attached to the pelvis. Back then the socket was plastic, and metal-on-plastic either didn't work or wore out. Gilbert did 29 of these before abandoning the procedure.

It took another 20 years for him to return to resurfacing. What convinced him was the highly polished Cobalt Chrome. "Now that we have metal-on-metal articulations we can go back to it," Gilbert says, "because metal-on-metal works."

As proof, he cites 60,000 BHR surgeries done since 1997, when it was perfected by its inventor Derek McMinn, operating in Birmingham, England. McMinn has done 3,000 himself, and Gilbert went over to Birmingham to train with McMinn last March.

They call orthopedic surgery "human carpentry," and for his first BHR Gilbert has brought along some muscle. First there is his partner in surgery, Dr. Peter Callander, 41. Next to him is Dr. Marc Thomas, an Australian rugby player and surgeon, who has gone over to the other side and now represents Smith & Nephew Orthopaedics, manufacturers of the BHR, based in Memphis.

"It's the premiere device in hips, no doubt," says Thomas, who has been in on 1,000 of these operations, though in British-style understatement, says, "I've done a few." Backing up Thomas is Matt Bouza, who played eight years in the NFL and is Northern California Sales Director for Smith & Nephew.

The patient, Stonich, is bigger than either ex-athlete at 6-feet 4 inches and 240 pounds. He'll be up to 241 when these metal parts are sewn into him.

To begin the hip resurfacing surgery, Stonich is given regional anesthetic, below the waist. Then he's turned on his right side with his left knee up. Once opened up, the soft tissue is released to expose the hip-joint capsule. Then the hip is dislocated. Callander, throws the gimp leg over his right shoulder, then his left, so the femoral head pops out. The leg will flop in any old direction, once disconnected from the pelvis.

A year ago, Stonich had arthroscopic surgery to clean out arthritis and bone spurs. The hope was that new cartilage would grow back, but it didn't.

A prosthetic hip works without cartilage. One problem with the total replacement, he says, is that the ball has to be smaller because it fits on a narrower part of the femur, leaving a higher risk of dislocation.

"This one almost never dislocates, so it's very good for athletic people, who want to hike, climb mountains." Thomas adds to that "downhill ski, continue to play tennis, rugby." Continuing rugby, is that a good thing? "No. Probably not. But when it's in your blood. . ."

Stonich played football at Sacred Heart, class of '66, then played semi-pro baseball for the San Jose Bees. But at this point he'd be happy just to get around a golf course. For 18 years he made his living on the stocking crew at grocery stores, loading pallets and lugging them down the aisles. When his hip went bad he switched to the crew on the Presidio Golf Course, until he had to quit that three years ago.

In testing, his femur was strong enough to support a resurfaced hip, a strict requirement. Thomas says out of 10 candidates, maybe one will be right for the BHR. Because doctors choose only active, and usually young patients with normal anatomy and good bone stock, the device has had a 98 percent survival rate in the eight years since it was introduced.

Once the hip is exposed, Gilbert goes to his tool bench, which consists of two tables of metal mallets, power drills, wrenches and saws, plus bone cement and a mixer. It takes an ortho-technician just to keep them all lined up in working order, and wipe the blood off after use.

After trimming away bone spurs, caused by the arthritis, Gilbert takes a power reamer to shape the acetabulum -- the cup-shaped cavity at the base of the hip bone. The metal cup has a taper-fit, coated in hydroxyapatite, the bone salt that gives compressional strength. It is pounded on with 35 whacks of a metal hammer. No screws required.

The finish carpentry is in carving the head of the femur to fit under the artificial ball joint. The BHR comes in 20 sizes, increasing in 2-millimeter increments, each in a sterilized box.

After measuring the top of Stonich's hip bone, Gilbert grabs the reamer and changes the bit, which he applies to the exposed hip bone to mold it to the under-surface of the cup. It works like a cheese grater. Curly shavings of white bone fly off it as he molds a perfect sphere.

"You're preserving as much bone as possible," Callander says, "and shaving it in order to have a perfect fit for the hat."

Using a drill bit, he augers down through the center of the femur. The stem of the hat is then pounded into the femoral canal -- 50 whacks.

"I didn't count them but I could feel he was hitting on it pretty good," says Stonich the next day. During surgery he was awake but feeling no pain. "It was cool. I liked it."

The end is near when the bone cement gets mixed. "That's the smell of victory," says Thomas, absorbing the aroma. The shiny new hip joint is then connected. A nurse counts the sponges to make sure none have been left behind.

Stonich heard that part too. "I thought, 'good,' " he says later. "That means they're double-checking." Then he is sewn up. End to end it takes about three hours.

A day after surgery, Stonich was lifting and bending the leg. The pain was a 2 on a scale of 10. Before surgery it was an 11, he says, already looking forward to getting the Birmingham Hip Resurfacing on his right side, in a year. That hip has cartilage.

"I think it's phenomenal," he says, planning his next tee time. "I think I'll be able to shoot in the '70s, take some money away from my grandson."